Honkamaa Kim, Paakinaho Anne, Tolppanen Anna-Maija, Kettunen Raimo, Hartikainen Sirpa, Tiihonen Miia
School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.
Br J Clin Pharmacol. 2024 Jun;90(6):1463-1470. doi: 10.1111/bcp.16035. Epub 2024 Mar 13.
Persons with diabetes may have an elevated risk of Parkinson's disease (PD). Statin use could also modify the progression of PD. The aim was to study whether there is an association between statin exposure and risk of PD in persons with diabetes.
A nationwide, nested case-control study restricted to people with diabetes was performed as part of nationwide register-based Finnish study on PD (FINPARK). Study included 2017 PD cases and their 7934 matched controls without PD. Persons with PD were diagnosed between 1999 and 2015, and statin use (1995-2015) was determined from Prescription Register. In the main analysis, exposure at least 3 years before outcome was considered. Cumulative exposure was categorized into tertiles, and associations were analysed with conditional logistic regression (adjusted with comorbidities and number of antidiabetic drugs).
Prevalence of statin use was similar in PD cases and controls, with 54.2% of cases and 54.4% controls exposed before the lag time (adjusted odds ratio [aOR] = 1.03; 95% confidence interval [CI]: 0.92-1.15). Those in the highest cumulative statin exposure tertile had higher risk of PD than statin nonusers (aOR = 1.22; 95% CI: 1.04-1.43), or those in the lowest cumulative statin exposure tertile (aOR = 1.29; 95% CI: 1.07-1.57).
Our nationwide study that controlled for diabetes duration and used 3-year lag between exposure and outcome to account for reverse causality does not provide support for the hypothesis that statin use decreases the risk of PD.
糖尿病患者患帕金森病(PD)的风险可能会升高。使用他汀类药物也可能改变PD的病程。本研究旨在探讨糖尿病患者中他汀类药物暴露与PD风险之间是否存在关联。
作为基于全国登记的芬兰PD研究(FINPARK)的一部分,开展了一项全国性的巢式病例对照研究,研究对象仅限于糖尿病患者。研究纳入了2017例PD病例及其7934例匹配的非PD对照。PD患者于1999年至2015年期间被诊断,他汀类药物使用情况(1995 - 2015年)通过处方登记确定。在主要分析中,考虑结局发生前至少3年的暴露情况。将累积暴露分为三分位数,并采用条件逻辑回归分析关联(根据合并症和抗糖尿病药物数量进行调整)。
PD病例和对照中他汀类药物的使用患病率相似,在滞后时间之前,54.2%的病例和54.4%的对照使用过他汀类药物(调整后的优势比[aOR]=1.03;95%置信区间[CI]:0.92 - 1.15)。累积他汀类药物暴露最高三分位数的患者患PD的风险高于未使用他汀类药物的患者(aOR = 1.22;95% CI:1.04 - 1.43),或高于累积他汀类药物暴露最低三分位数的患者(aOR = 1.29;95% CI:1.07 - 1.57)。
我们的全国性研究控制了糖尿病病程,并在暴露和结局之间采用3年的滞后时间以解释反向因果关系,该研究不支持他汀类药物使用可降低PD风险这一假设。